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Mycobacterium chelonae lumbar spinal infection.
N J Suttner1, Z Adhami, A R Aspoas
1Department of Neurosurgery, Oldchurch Hospital, Essex, UK.
British Journal of Neurosurgery
|August 2, 2001
Summary
A rare Mycobacterium chelonae lumbar spinal extradural abscess in a healthy adult required extensive treatment. Aggressive surgical debridement was crucial for achieving a cure after a prolonged, complicated course.
Area of Science:
- Infectious Diseases
- Neurosurgery
- Mycobacterial Infections
Background:
- Spinal extradural abscesses are uncommon, particularly those caused by non-tuberculous mycobacteria.
- Mycobacterium chelonae is an atypical mycobacterium that can cause opportunistic infections.
Observation:
- A previously healthy adult presented with a lumbar spinal extradural abscess caused by Mycobacterium chelonae.
- The patient experienced recurrent psoas abscesses and demonstrated multiantibiotic resistance.
- Treatment spanned 33 months, involving multiple surgical drainage procedures and antibiotic regimen adjustments.
Findings:
- Aggressive surgical debridement of the abscess was the definitive treatment for cure.
- Multiantibiotic resistance complicated the management of this mycobacterial infection.
- Recurrent psoas abscesses indicated the challenges in eradicating the infection.
Implications:
- This case highlights the potential for Mycobacterium chelonae to cause severe spinal infections.
- Effective management requires a multidisciplinary approach, including infectious disease specialists and neurosurgeons.
- Surgical intervention, particularly thorough debridement, is critical for successful outcomes in complex mycobacterial spinal abscesses.